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单侧双通道内镜在成人胸部疾病中的拓展应用:三例报告及文献复习

Expanded application of unilateral biportal endoscopy in adult thoracic disease: report of three cases and literature review.

作者信息

Kim Hun-Chul, Ko Young-Il, Ko Myung-Sup, Kim Sang-Il, Kim Young-Hoon

机构信息

Endoscopic Spine Surgery Center, Dae-Chan Hospital, 590, Inju-daero, Namdong-gu, Incheon, Republic of Korea.

Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea.

出版信息

Eur Spine J. 2025 Jan;34(1):372-379. doi: 10.1007/s00586-024-08501-5. Epub 2024 Nov 29.

Abstract

BACKGROUND

Traditional surgery for degenerative thoracic disorder can be extremely invasive and accompanied by complications. Unilateral biportal endoscopy (UBE), a newly developed technique in the field of spin surgery, is minimally invasive and its popularity and indications have been increasing. In this study, we report three cases of different thoracic diseases treated using UBE.

METHODS

The first case was a 50-year-old male patient with lower extremity tingling sense and right thigh anterior aspect radiating pain. Bilateral decompression and removal of ossification of the ligamentum flavum (OFL) was done. The second case was a 75-year-old female who had symptoms of gait disturbance and motor weakness due to thoracic myelopathy in T12-L1. We performed canal decompression and discectomy using the far-lateral approach. The third case was a 69-year-old female with poor medical condition due to lymphoma who had symptoms of right intercostal pain that occurred after T12 acute compression fracture. UBE treatment was decided, and nerve decompression was performed.

RESULTS

In the first case, the tingling sense due to OYL improved three months after the surgery. In the second case, the right lower extremity radiating pain and gait disturbance showed improvement after surgery, but motor weakness continued until four months after surgery. In the third case, intercostal pain showed improvement immediately after surgery.

CONCLUSION

Although UBE surgery is limited in completely replacing traditional treatments for degenerative thoracic disease, it offers the advantages of rapid rehabilitation and short-term hospitalization and can be a good surgical treatment option.

摘要

背景

传统的退行性胸椎疾病手术创伤极大且伴有并发症。单侧双通道内镜技术(UBE)是脊柱外科领域新开发的技术,具有微创性,其受欢迎程度和适应证不断增加。在本研究中,我们报告了3例采用UBE治疗的不同胸椎疾病病例。

方法

第一例为一名50岁男性患者,有下肢刺痛感及右大腿前侧放射性疼痛。进行了双侧减压及黄韧带骨化(OFL)切除术。第二例为一名75岁女性,因T12-L1胸椎脊髓病出现步态障碍和运动无力症状。我们采用远外侧入路进行了椎管减压和椎间盘切除术。第三例为一名69岁女性,因淋巴瘤身体状况较差,在T12急性压缩性骨折后出现右肋间疼痛症状。决定采用UBE治疗并进行了神经减压。

结果

第一例中,术后3个月OYL引起的刺痛感有所改善。第二例中,术后右下肢放射性疼痛和步态障碍有所改善,但运动无力持续至术后4个月。第三例中,术后肋间疼痛立即有所改善。

结论

虽然UBE手术在完全替代退行性胸椎疾病的传统治疗方面存在局限性,但它具有康复快、住院时间短的优点,可成为一种良好的手术治疗选择。

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